The man who played a part in a historical discovery

Who is Phineas P Gage?

Phineas Gage is one of the most known case in neuroscience. He suffered a brain injury due to a iron rod which destroyed his skull and frontal lobe.

Phineas P Gage was a railway construction workman survived the accident in which he had a large iron rod in his head and it smashed his frontal lobe area of brain on September 13th, 1848 when he was 25 years old. After the accident he made a recovery lived 12 years more until he experienced epilepsy complications in May 21st, 1860.

Phineas Gage’s Accident

On September 21, 1848, The Boston Post reported on the incident. The article was called “Horrible Accident” and said: As Phineas P. Gage, a foreman on the railroad in Cavendish, was yesterday engaged in tamping for a blast, the powder exploded, carrying an instrument through his head an inch in length, which he was using at the time. The iron entered on the side of his face, shattering the upper jaw, and passing back of the left eye, and out at the top of the head.

43 inches long and 1.25-inch diameter rod hurtling upward injured him. The rod penetrated him left cheek and his brain then after his skull it felt on the ground 80 feet away from him.

Surprisingly he wasn’t totally unconscious. He was able to speak and walk with the rod in his head. He went to the doctor in town with help Dr. Edward H. Williams was the first physician who saw him, and his statement was that “I first noticed the wound upon the head before I alighted from my carriage, the pulsations of the brain being very distinct. Mr. Gage, during the time I was examining this wound, was relating the manner in which he was injured to the bystanders. I did not believe Mr. Gage’s statement at that time, but thought he was deceived. Mr. Gage persisted in saying that the bar went through his head… Mr. G. got up and vomited; the effort of vomiting pressed out about half a teacupful of the brain, which fell upon the floor.”

Although Gage has lost his one eye and has an injured his frontal lobe he wasn’t totally unconscious, he was able to speak and also, he was able to remember his colleagues’ names and he stated his opinion that not see his friends until he will be able to work again in “a day or two” anyhow.

Physical Recovery

In the months that followed, Gage returned to his parent’s home in New Hampshire to recuperate. When Harlow saw Gage again the following year, the doctor noted that “Gage had lost vision in his eye and was left with obvious scars from the accident, he was in good physical health and appeared recovered.”

More or less 10 days he was in semi-comatose state. (Until October 3rd 1848). Furthermore, in one month he was able to get out of the bed (October 11th 1848). In a one month he could go outside.

Cognitive Results of the Accident

Not only his physical health but also his cognitive functions was improving. For instance, he could remember how the accident was and how long has it been since the accident.

Nevertheless, after the physical recovery, according to his relatives his developed some personality changes because of his injury.

According to statements of his relatives he lost his inhibitions in some social situations his behaviours are inappropriate and out-of-control and immature.

All these social outcomes led to examination of frontal cortex. This case study displayed that some cognitive functions such as social cognition, decision-making, executive functions have connection with frontal lobe.

John Martyn Harlow who is the doctor treated Gage a few months after the accident and according to his statements Gage’s friends said the Gage is no longer Gage anymore. His personality totally changed and in his new situation Gage cannot follow the plans. That’s a big difference when his past is considered. Because, he was known as a determined, hardworking, energetic and pleasant person and according to the railroad construction company, that he was working until the accident, Gage was known with being a hardworking and model foreman, yet in this his new situation company reject Gage to employ him again. Because of the injury he became unconscious, aggressive, unable to perform a task. Thus, Gage found other jobs which are more stable.

Gage is one of the most important case in neuroscience since it put forward the connection between brain injury and personality change. Furthermore, currently it is widely known that prefrontal cortex is an important area for some cognitive functions such as executive functions, inhibition, decision making, and social cognitive functions etc.

After all

He died due to epilepsy complications in 1860 and his skull is at Warren Anatomical Museum at Harvard Medical School with the iron rod with the explanation that “This is the bar that was shot through the head of Mr Phinehas [sic] P. Gage at Cavendish, Vermont, Sept. 14 [sic], 1848. He fully recovered from the injury & deposited this bar in the Museum of the Medical College of Harvard University. Phinehas P. Gage Lebanon Grafton Cy N-H Jan 6 1850.”